An autistic young man with prior hospitalizations for chronic constipation and megacolon was admitted to a hospital in London, UK with a markedly distended abdomen. A CT scan showed a dilated rectum and colon with a diameter as large as 18 cm (7 inches).
He was treated conservatively for two days with laxatives. Enemas were ordered, but the patient declined. He then developed peritonitis, kidney dysfunction, mental status changes, and metabolic acidosis.
